Research shows that diagnosis with the blood-borne liver disease hepatitis C can lead to significant changes in intimate relationships, including a reduction in sexual contact and avoidance of new relationships. This article examines hepatitis C health promotion materials and their treatment of sexuality and sexual transmission. The article analyses 21 Australian hepatitis C health promotion resources collected as part of research degree project exploring the interrelationships between hepatitis C, injecting drug use, HIV and the body. It uses the work of theorist Margrit Shildrick on the ‘anomalous’ body, and a discourse analysis method, to understand these interrelationships and their metaphorical and symbolic implications. Our analysis shows that health promotion materials regularly present information about sexual transmission in ways likely to add to confusion and uncertainty about risk. Despite regular acknowledgements that hepatitis C is not a sexually transmissible infection, some resources place an inappropriately heavy focus on the possibility of hepatitis C transmission via heterosexual activity. Others contain mixed messages about the possibility for disease transmission through sex, at the same time enjoining hepatitis C positive readers to practise safe sex. We argue that these injunctions are linked to the ways that the resources figure people living with hepatitis C as intrinsically anomalous. In doing so, the resources run the risk of inadvertently naturalising stigma, anxiety and fear surrounding intimate contact. The article concludes by noting that agencies responsible for the delivery of health promotion need to carefully examine the messages they produce if they are to avoid creating uncertainty and anxiety about the implications of hepatitis C for sexuality and intimacy.
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The natural history of hepatitis C disease varies significantly for each individual, but in general it is a slowly progressing condition. It is estimated that 70–80 per cent of people who are exposed to hepatitis C do not clear the virus and develop chronic infection. Of these, between 30–40 per cent remain asymptomatic and 60–70 per cent experience consistent or sporadic abnormal liver function. After 20 years, 5–10 per cent of those infected progress to cirrhosis and after 40 years 3–5 per cent develop liver cancer or liver failure (Dore, 2001).
REVISED FROM: Some people, unable to identify any other risk factors, believe they may have contracted hepatitis C sexually. In addition, some research suggests that a small percentage of people do contract hepatitis C through sexual contact. Thus, transmission of hepatitis C during sex is seen as possible but believed to be rare [emphasis added] (Hepatitis NSW, 2008; Hepatitis NSW, 2009, p. 64). Hepatitis NSW (2008) Hep C factsheets: Sex and Hepatitis C transmission. Hepatitis NSW, NSW. TO: Some research suggests that a small percentage of people do contract hepatitis C through blood to blood contact that may occur during sexual contact. Thus, transmission of hepatitis C during sex is seen as possible but believed to be rare (Hepatitis NSW, 2011 factsheet). REMOVED FROM: Hepatitis NSW (2009) What you need to know: A guide to hepatitis C. Hepatitis NSW, NSW.
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The interviews referred to in this article were conducted as part of an Australian Research Council-funded study entitled ‘Under construction: The social and cultural politics of hepatitis C’ (DP0877944) and a Masters Project. The former was conducted at Monash University in partnership with the National Drug Research Institute and the National Centre in HIV Social Research. Chief investigators for the project ‘Under construction’ were Suzanne Fraser, Carla Treloar and David Moore. The authors would like to extend their thanks to the organisations that assisted in recruitment for the study, and most importantly of all, to the study participants who gave so generously of their time.
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Lenton, E., Fraser, S. Hepatitis C health promotion and the anomalous sexual subject. Soc Theory Health 14, 44–65 (2016). https://doi.org/10.1057/sth.2015.6
- hepatitis C
- health promotion
- sexual transmission
- anomalous bodies